Responsible for the auditing of inpatient coders and/or inpatient 'audit the auditors' to ensure coding accuracy and DRG accuracy of a minimum of 95% is met
Perform quality checks/audits on visits coded as per client SOPs
Perform calibration audits
Suggest improvements and schedule calibration sessions with offshore team counterparts and leaders
May assist in preparing audit reports, share direct feedback to coders and auditors on areas of opportunity, participate in client interactions and internal stakeholder meetings
Firm understanding of the clinical documentation guidelines
Monitor compliance of coding guidelines and ensure errors are identified during audits are corrected as appropriate, and corrective action is initiated before the claim is rebilled to the insurance
Conduct analysis and present summary of findings to leadership in a clear, concise, convincing, and actionable format
Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes (ICD-PCS), MS-DRG, APR DRG, POA, SOI & ROM assignments
Ensures capture/reporting of appropriate code(s) by utilizing coding guidelines established by various entities

Current permanent United States Work Authorization required
2+ years previous experience as an inpatient coding auditor
3+ years previous experience in coding inpatient hospital accounts
Advanced proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint)
Analytical skills (problem solving, quantitative, workflow process, etc.)
Excellent time management skills; organized; ability to prioritize completing multiple tasks on schedule in a deadline driven environment
Requires the use of independent judgement, discretion and decision-making abilities
Ability to ramp up on a client’s environment, processes, historical context, and systems to provide support to an engagement as soon as possible
Financial acumen and analytical skills are required
Familiarity with revenue cycle systems; deep understanding of revenue cycle process flow and financial analysis
Desire to work as part of a team in a partnership role
Strong oral and written communication skills, analytical skills, ability to work independently, and be self-motivated are required
Flexible and adaptable to changes.

Inpatient Coding Auditor

Key skills